Does cerclage wiring interfere with fracture healing of osteosynthesis in comminuted midshaft clavicle fractures? A multicenter study

Abstract Background: Patients suffering from medial clavicle fractures combined with displacement need surgical intervention. This research reports the effect of double-plate fixation as an innovative procedure in the treatment of extremely medial clavicle fractures.Methods: Nine patients complaint of extremely medial clavicle fracture were enrolled in this research from Mar 2017 to March 2018. Patients were treated with an open reduction and internal fixation using the double-plate technique. Postoperative X-ray was taken regularly to observe the fracture healing at each visit, and the related complications were also recorded. The rating score systems of Constant Murley score of treated shoulder and contralateral shoulder, Rowe score as well as American Shoulder and Elbow Surgeons (ASES) were questionnaire to evaluate postoperative shoulder joint function.Results: All patients achieved postoperative fracture healing with no complications. Only one patient complained of slight restriction, two patients complained of pain during overhead work, and another patient occurred plate breakage. Meanwhile, the Constant Murley scores of treated and contralateral shoulder were 94.1 and 98.5 points, respectively, indicating the similar shoulder function. Furthermore, the Rowe and ASES scores of the involved shoulder were 96.7 and 96.3 points at average, respectively.Conclusions: It is the first time to introduce the surgical technique of vertical double-plate fixation for stable fixation of extremely medial clavicle fractures, which could provide the surgeons an alternative method for this type of fracture.

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Process of Fracture-Healing in Diaphysis of Tubular Bones-A Multicenter Study-

Orthopedics & Traumatology ◽

10.5035/nishiseisai.60.763 ◽

2011 ◽

Vol 60 (4) ◽

pp. 763-767

Author(s):

Takao Mae ◽

Akihiko Asami ◽

Hideyuki Semba ◽

Shinichiro Hara ◽

Itaru Furuichi ◽

...

Keyword(s):

Fracture Healing ◽

Multicenter Study ◽

Tubular Bones

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Reliability of Radiographic Assessments of Adolescent Midshaft Clavicle Fractures by the FACTS Multicenter Study Group

Journal of Orthopaedic Trauma ◽

10.1097/bot.0000000000000877 ◽

2017 ◽

Vol 31 (9) ◽

pp. 479-484 ◽

Cited By ~ 10

Author(s):

Ying Li ◽

Kyna S. Donohue ◽

Christopher B. Robbins ◽

Andrew T. Pennock ◽

Henry B. Ellis ◽

...

Keyword(s):

Multicenter Study ◽

Study Group ◽

Clavicle Fractures ◽

Multicenter Study Group

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Anatomic Locking Plate Fixation and Coracoclavicular Stabilisation with Multistrand Titanium Cable for Unstable Distal Clavicle Fracture

Journal of Medical Imaging and Health Informatics ◽

10.1166/jmihi.2021.3581 ◽

2021 ◽

Vol 11 (5) ◽

pp. 1477-1480

Author(s):

Zhong-Guo Liu ◽

Yue-Wei Yu ◽

Huang-Lin Xie ◽

Qing-Xin Xie

Keyword(s):

Fracture Healing ◽

Locking Plate ◽

Clavicle Fracture ◽

Clinical Effects ◽

Distal Clavicle ◽

Distal Clavicle Fracture ◽

Clavicle Fractures ◽

Anatomic Locking Plate ◽

Distal Clavicle Fractures

Objective: The aim of this study was to introduce a modified surgical procedure using anatomic locking plate (ALP) fixation and coracoclavicular (CC) stabilisation with multistrand titanium cable (MTC) to repair unstable distal clavicle fractures, and to estimate clinical effects of these people. Materials and methods: Between July 2016 and April 2018, we treated 7 patients with unstable distal clavicle fracture by ALP fixation and CC stabilisation with MTC. After the surgery, we followed up every patient for at least 24 months and analysed their clinical results. Results: The average term required for fracture healing was 9.9 (range, 9–12 weeks) and all cases are successful in fracture healing. The average Constant score was 94.6 points (range, 92–100) at the last follow-up; the modified University of California, Los Angeles (UCLA) shoulder rating scale was 33.4 points (range, 31–35) at the last follow-up. There was no infection, hardware failure and iatrogenic fracture in all the cases. Conclusions: ALP fixation and CC stabilisation with MTC is a really good method for the treatment of unstable distal clavicle fractures. This surgical technique can provide stable fixation for early functional exercise, and prevent extra shoulder joint damage.

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Changes in Superior Displacement, Angulation, and Shortening in the Early Phase of Healing for Completely Displaced Midshaft Clavicle Fractures in Adolescents: Results from a Prospective, Multicenter Study

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2021.05.006 ◽

2021 ◽

Author(s):

Andrew T. Pennock ◽

Benton E. Heyworth ◽

Tracey Bastrom ◽

Donald S. Bae ◽

Kelly E. Boutelle ◽

...

Keyword(s):

Multicenter Study ◽

Early Phase ◽

Prospective Multicenter Study ◽

Clavicle Fractures

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Comparison of the effect of two internal fixation methods for proximal clavicle fractures

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.66.5.654 ◽

2020 ◽

Vol 66 (5) ◽

pp. 654-658

Author(s):

Haining Xu ◽

Yan Nie ◽

Lifang Han ◽

Liang Li ◽

Haitao Sui

Keyword(s):

Blood Loss ◽

Internal Fixation ◽

Fracture Healing ◽

Clinical Symptoms ◽

Operation Time ◽

Healing Time ◽

Fixation Methods ◽

Plate Group ◽

Clavicle Fractures

SUMMARY OBJECTIVE To compare the effect of two internal fixation methods in the treatment of proximal clavicle fractures. METHODS Fifty patients with proximal clavicle fractures received surgical treatment. They were divided into a clavicular T-plate group and a double mini-plates group. The duration of the operation, blood loss during the operation, fracture healing time, and incision infection were evaluated between the two groups. RESULTS Operation time (t=2.063, P=0.058), intraoperative bleeding (t=1.979, P=0.062), and fracture healing time (t=1.082, P=0.066) were not statistically significant in the two groups. The patients were followed up for 12-18 months; one patient in the T-plate group had early removal of nails, but no clinical symptoms. At the 2-month follow-up, the ASES score in the double mini-plates group was significantly better than in the T-plate group (P<0.001); but at the 6-month follow-up, 1-week before removal of internal fixation and the final follow-up, the two groups had no significant differences (P>0.05). CONCLUSIONS Both internal fixations have similar clinical results in the duration of operation, blood loss during the operation, and fracture healing time. The double mini-plates fixation presents advantages by reducing complications and speeding fracture healing; thus it is a more effective method to treat proximal clavicle fractures.

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